cardiology/renal/repro 1-27 54% Flashcards Preview

STEP I 2014 > cardiology/renal/repro 1-27 54% > Flashcards

Flashcards in cardiology/renal/repro 1-27 54% Deck (28):
1

relation of aorta and IVC

right side-IVC and left side-aorta

2

75 year old pt with a fib and past history of thromboembolic dz, give warfarin and not heparin because

heparin is used to for antiplatelet therapy in pts under 75 w/o past history of thromboembolic dz and low risk of a fib. give warfarin for higher risk pts

3

drug that can replace captopril if pt has cough is losartan and not exenatide or sitagliptin because

captopril and ACE I can be replaced with and ARBs losartan
exenatide-is glucagon like peptide (GLP-1) used to treat DM2.
sitagliptin is dipeptidyl peptidase-4 inhibitor (DPP-4) used to treat DM2

4

what is used to measure cardiac function after MI:
-8 hrs
-8-24hrs?

- troponin T or troponin I
-CK-MB or total creatine kinase

5

primary force of coronary artery flow?

aortic pressure not ventricular contraction

6

removal or kidney or any organ causes CO and TPR and total renal blood flow and BP to

CO decreases, TPR increases, total renal flow decreases, BP remains constant b/c organs are arranged in parallel.
1/total resistance=1/R1 +1/R2 + 1/R3

7

pt with red, swollen, tender breast with firm mass has dermal lympathic invasion by cancer cells and not epidermal invasion or fat necrosis because

pt has inflammatory breast cancer-cancer cells invade dermal lymphatics and cause pea d-orange
epidermal invasion by cancer cells-Paget's disaese
fat necrosis-follows trauma can sometimes be confused with breast cancer

8

drug that an vasodilate and decrease relaase of insulin

diazoxide-K+ channel opener, used for emergency HTN and hypoglycemia caused by hyperinsulinism.

9

endocarditis complicated by staph aureus will likely result in pulmonary abscess and not mitral valve stenosis because

staph aureus will have vegetations on the tricuspid valve which can break of (septic emboli) into pulmonary circulation.
mitral valve stenosis is seen in rheumatic fever group A strep

10

compensated aortic coarctation.

flow above and below level of coarctation is normal. resistance changes to compensate.

11

renal failure in the presence of HTN and anemia is caused by ADPKD and not renal cell carcinoma because

ADPKD can cause HTN b/c of renin release and lack of EPO, renal cell carcinoma does not cause HTN

12

pentoxifylline

lowers blood viscosity and improves RBC flexibility- used to treat intermittent claudication (cramp in leg due to arterial clot), side effects- dyspnea and mild hypotension

13

increase in pulse pressure

increase in systolic pressure-arteriolosclerosis. normal is 40 (120-80`)
decrease in diastolic pressure- PDA (blood flows from flows from ductus to pulmonary artery) or aortic regurg (back flow during diastole)

14

decrease in pulse pressure

mitral valve stenosis, aortic pressure is constant but atrial pressure during diastole increases

15

infectious dz leading to aortic aneurysm due to destruction of vasa vasorum

syphillus

16

pt with abdominal distention and marroon colored stool has what? what is one feared complication?

liver disease which can lead to portal HTN and variceal rupture (rupture of azygous vein-a major out like for esophageal vein which can become engorged from connect to hepatic portal vein)

17

thiazide causes an increase in ALD and not serum Na+ because

it block NaCl channel in DCT. leading to salt wasting, ALD will increase in an effect to retain salt and can cause a decrease in K/H levels

18

newborn with transposition of great vessels should be given alprostadil and not idomethacin because

idomethacin would close PDA while alprostadil or misoprotol will keep it open (PGE1 analog)

19

diastolic decrescendo murrmur on lower left sternal border

aortic regurg

20

veinal drainage of right ovary. left

pampinform plexus-overian vein, IVC
pampinformplexus-overian vein-renal vein-IVC

21

cervix veinal dramage

cervical vein-uterine vein-external iliac vein

22

holosystolic apical murrur that radiates to axilla and accompanied by a thrill,

mitral regurg. maya lso have wide splitting of S2 b/c of early closure of aortic valve

23

systolic ejection murrur, thrill, harsh, and radiates to carotids

aortic stenosis

24

diastolic murrmur with love S1 and opening snap below S2

mitral stenosis

25

high pitched pansystolic murrmur in 4th intercostal space parasternal region, increased during respiration and reduced in standing position and during valsalva maneuver

tricuspid regurg

26

verapamil

Ca2+ blocker, used to control rapid atrial fib and flutter, prefered in pt wirh pulomnary dz b/c not bronchospasm effect of beta-blockers

27

complication of MI after
-4-8 wks
-5-7 days
-before 5 days

-ventricular aneruysms
-interventricular septal rupture
-left ventricular free wall rupture

28

heart condition associated with SLE

Libman-Sacks endocarditis